Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia最新文献

{"title":"Effectiveness of single-dose methotrexate in the treatment of ectopic pregnancy: a retrospective study.","authors":"Letícia Pereira Mendonça, Eduardo Cunha da Fonseca","doi":"10.61622/rbgo/2026rbgo28","DOIUrl":"10.61622/rbgo/2026rbgo28","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate the effectiveness of Methotrexate in clinical treatment of ectopic pregnancy and analyze the influence of clinical and laboratory variables on the treatment outcome.</p><p><strong>Methods: </strong>It was a retrospective study of 95 patients undergoing clinical treatment with Methotrexate at a private tertiary hospital in the metropolitan region of Belo Horizonte. Variables such as age, presence of pelvic pain, previous ectopic pregnancy, initial beta-hCG level and largest adnexal mass measurement were analyzed. The theoretical framework followed a data search in PubMed, selecting 17 articles in total.</p><p><strong>Results: </strong>The clinical success rate with a dose of Methotrexate was 71,6%. Among the variables evaluated, only the initial beta-hCG value showed statistical significance with the outcome, therefore, higher the beta-hCG, lower the chance of treatment effectiveness, with a p-value of 0.002. The other variables analyzed did not show any significant association.</p><p><strong>Conclusion: </strong>Methotrexate has been shown to be effective in most cases of ectopic pregnancy, with the initial beta-hCG value standing out as a predictor of treatment failure. The findings reinforce the importance of adequate patient selection and laboratory monitoring in clinical follow-up.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemostatic safety profile of estetrol vs. ethinylestradiol in oral contraceptives: a systematic review and meta-analysis.","authors":"Maria Julia Lemos, Jacqueline Maia Ferraz, Laura Fonseca Queiroz, Alice França Diniz, Celene Maria Longo da Silva, Priscila Luiza Dos Santos, Patricia Myriam Antunes de Oliveira Gomide, Andrea Mora De Marco Novellino","doi":"10.61622/rbgo/2026rbgo27","DOIUrl":"10.61622/rbgo/2026rbgo27","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the hemostatic profile of estetrol/drospirenone (E4/DRSP) compared with ethinylestradiol/drospirenone (EE/DRSP) in adult women.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of randomized controlled trials (RCTs) was performed according to PRISMA guidelines. Eligible studies compared E4/DRSP with EE/DRSP in adult women and assessed coagulation, anticoagulation, or fibrinolytic markers. Three RCTs (n=183) met inclusion criteria. Data were extracted independently, and pooled mean differences (MD) were calculated using random-effects models.</p><p><strong>Results: </strong>Compared to EE/DRSP, E4/DRSP was associated with higher protein S activity (MD = 21.23; 95% CI: 11.83 to 30.64; p<0.00001) and lower levels of fibrinogen (MD = -24.17; 95% CI: -39.15 to -9.19; p=0.002), plasminogen (MD = -27.28; 95% CI: -27.28 to - 22.89; p<0.00001), and SHBG (MD = -183.38; 95% CI: -183.38; 95% CI: -210.93 to -155.84; p<0.00001). No significant differences were observed for D-dimer and antithrombin. Protein C activity was higher in the EE group, though this was an isolated finding with limited interpretability.</p><p><strong>Conclusion: </strong>E4/DRSP demonstrates a more favorable hemostatic profile than EE/DRSP, potentially reducing thrombotic risk. Despite the limited number of RCTs, consistency across markers supports E4 as a safer estrogenic component for contraceptive formulations, with implications for women at increased risk of venous thromboembolism.<b>PROSPERO registry</b>: #CRD420251074961.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of different EMA/CO treatment regimens in women with gestational trophoblastic neoplasia: brazilian multicenter retrospective cohort study.","authors":"Laís Cristhine Santos Souza, Michelle Samora de Almeida, Antonio Braga, José Mauro Madi, Edward Araujo Júnior, Alberto Borges Peixoto, Marcio Bezerra Barcellos, Lucas Ribeiro Borges de Carvalho, Roney Cesar Signorini, Sue Yazaki Sun","doi":"10.61622/rbgo/2026rbgo52","DOIUrl":"10.61622/rbgo/2026rbgo52","url":null,"abstract":"<p><strong>Objective: </strong>To compare the clinical outcome of women with gestational trophoblastic neoplasia (GTN) treated with the conventional EMA/CO (etoposide, methotrexate, actinomycin-D, cyclophosphamide, vincristine) with those treated with the modified EM/CO regimen.</p><p><strong>Methods: </strong>Brazilian multicenter retrospective cohort study evaluated medical records of women diagnosed with GTN who were treated with the standard EMA/CO or with the modified regimen in which actinomycin-D was suppressed (EM/CO). The primary outcome was the occurrence of remission following chemotherapy treatment.</p><p><strong>Results: </strong>Remission rate with EMA/CO was 85.3%, with 14.7% of women showing chemoresistance, while with EM/CO, the remission rate was 72.7%, with 27.3% of women chemoresistance, without statistical difference between the groups. A total of 142 women were analyzed, of whom 109 were treated with EMA/CO and 33 received EM/CO. Women who used the EM/CO had higher prevalence of invasive mole (51.5% vs. 14.7%, p<0.0001), lower prevalence of choriocarcinoma (9.1% vs. 26.6%, p=0.035), and lower prevalence of metastases (33.3% vs. 61.5%, p=0.004) compared to women who received the EMA/CO. Women with risk score ≥ 7 had higher prevalence of recurrence (61.5% vs 10.0%, p=0.005) and chemoresistance using the EM/CO (53.8% vs 10.0%, p=0.013) compared to women with score ≤ 6. The pre-treatment serum hCG levels was a moderately significant predictor (AUC: 0.77, 95%CI 0.66-0.88, p<0.0001) for identifying chemoresistance. The number of EM/CO cycles was a strong significant predictor (AUC: 0.81, 95%CI 0.66-0.96, p<0.0001) for identifying toxicity to chemotherapy.</p><p><strong>Conclusion: </strong>EM/CO had higher prevalence of need for second-line treatment, and chemoresistance.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Descriptive analysis of genital colonization across gestational trimesters in pregnant women with different obstetric histories.","authors":"Carolina Pereira Andrade, Camila Marconi, Márcia Guimarães da Silva, Newton Sérgio de Carvalho","doi":"10.61622/rbgo/2026rbgo29","DOIUrl":"10.61622/rbgo/2026rbgo29","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to assess the <i>Ureaplasma parvum</i> variation of genital colonization during pregnancy with an exploratory approach among women with term and preterm birth histories.</p><p><strong>Methods: </strong>Prospective case-control study of 24 pregnant women with history of full-term pregnancy and 26 pregnant women with history of prematurity whose endpoint was to assess the colonization pattern of these agents with a vaginal/cervical sample collected at the beginning of each trimester of gestation. Collected data: sociodemographic characteristics, previous diseases, gynecological and obstetric history, and microorganisms in vaginal secretion samples by real-time polymerase chain reaction (PCR).</p><p><strong>Results: </strong>The overall number of cases positive for at least one microorganism was 18 (36.0%). A significantly higher positivity rate was observed in the second and third trimesters in both study groups compared with the first trimester (p<0.001). The microorganisms identified in the vaginal environment were <i>Ureaplasma parvum</i> (66.6%), <i>Mycoplasma hominis</i> (16.7%), and both (16.7%), and the frequency of both these microorganisms was comparable in both groups at each pregnancy trimester (p for all = nonsignificant), but with a difference between the trimesters. Prematurity in the current pregnancy occurred in a single case (6.7%) in a pregnant woman without history of prematurity in the previous pregnancy (p=1.00).</p><p><strong>Conclusion: </strong>The most frequently identified microorganism was <i>Ureaplasma parvum</i>, and the overall incidence of positive cases including all microorganisms was 36.0%. Although <i>Ureaplasma parvum</i> was the most frequently identified microorganism, the sample was not powered to assess its association with prematurity.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of preterm birth and congenital anomalies: findings of a Brazilian multicenter study.","authors":"Marcelo Luis Nomura, Luiz Carlos Santos-Junior, Jose Paulo Siqueira Guida, Tabata Zumpano Santos, Giuliane Jesus Lajos, Rodolfo Carvalho Pacagnella, Patricia Moretti Rheder, Ricardo Porto Tedesco, Renato Teixeira Souza, Maria Laura Costa, Renato Passini-Junior, Jose Guilherme Cecatti","doi":"10.61622/rbgo/2026rbgo35","DOIUrl":"10.61622/rbgo/2026rbgo35","url":null,"abstract":"<p><strong>Objective: </strong>to analyze the prevalence of congenital anomalies among women who had preterm births, their association with gestational age, characteristics of pregnancy termination and perinatal outcomes.</p><p><strong>Methods: </strong>A secondary analysis of the Brazilian Multicenter Study on Preterm Birth (EMIP), a multicenter cross-sectional study in 20 maternity hospitals, comparing cases of preterm birth with and without anomalies. A random sample of term births served as controls. The risk of malformations was estimated by maternal age, gestational age, type of onset of labour, mode of delivery, and neonatal outcomes using OR (95%CI) for categorical variables.</p><p><strong>Results: </strong>Among 4,150 preterm births and 1,146 selected term controls, congenital anomalies were found in 7.21% of cases (8.36% in preterm vs. 3.1% in term). Preterm birth increased the risk of anomalies by 2.89-fold (95% CI: 2.03-4.13). Cardiovascular anomalies were most common (19.1%), followed by central nervous system anomalies (18.8%) and abdominal wall defects (12.5%). The highest risk was observed at 28-31 weeks (OR 4.57, 95%CI 3.01-6.94). Elective cesarean delivery was more frequent among neonates with abnormalities (40.1% vs. 32.1%, OR 1.41, 95% CI: 1.13-1.77). Neonates with abnormalities had a higher risk of low 5^th minute Apgar scores (OR 2.68, 95% CI: 2.01-3.56), birth weight <1.5 kg (OR 1.46, 95% CI: 1.14-1.87), and adverse outcomes such as NICU admission, sepsis, and neonatal mortality (OR 6.0, 95% CI: 4.58-7.85).</p><p><strong>Conclusion: </strong>Prematurity is associated with congenital anomalies, leading to increased neonatal morbidity, mortality, and admission to NICU.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual behavior of women who have sex with women.","authors":"Debora Aiesha Leite Cantelli, Sérgio Henrique Pires Okano, Luiz Gustavo Oliveira Brito, Rosana Maria Reis, Ana Carolina de Sá Rosa-E-Silva, Lúcia Alves da Silva Lara","doi":"10.61622/rbgo/2026rbgo34","DOIUrl":"10.61622/rbgo/2026rbgo34","url":null,"abstract":"<p><strong>Objective: </strong>To assess sexual behavior, use of sexually transmitted infection prevention methods and the sexual function, among women who have sex with women.</p><p><strong>Methods: </strong>This nationwide cross-sectional study was conducted from February 2023 to April 2024 using the Respondent Driven Sampling method. Women who have sex with women (WSW) with vaginas and neovagina, aged 18-40 years were included. Data on sociodemographic, clinical history, sexual behavior, and STI prevention were collected. Sexual function was assessed using the Female Sexual Function Index (FSFI).</p><p><strong>Results: </strong>A total of 371 forms were analyzed (mean age: 28.7 ± 6.9 years). 82.0% participants reported having penile-vaginal intercourse. Nearly all reported both performing (367; 98.0%) and receiving (360; 97.0%) oral sex. 351 participants (94.6%) reported receptive and 324 (87.4%) reported insertive penetration. Insertive anal sex was reported by 94 participants (25.3%), and receptive anal sex by 87 (23.4%). Only 10 participants (2.7%) reported using barrier methods during oral sex. Based on FSFI scores, 115 participants (31.0%) were at risk for sexual dysfunction.</p><p><strong>Conclusion: </strong>Most WSW in Brazil engage in oral and vaginal sex, but the report of STI prevention remains mostly limited to the male condom, with little use of barriers in oral or digital practices. HPV and hepatitis vaccination status are high. 115 participants (31.0%) scoring below the cutoff of 26.55. No significant difference in risk of development of sexual dysfunction between age, educational level, sexual orientation and gender identity.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of timely cardiovascular risk screening in patients with premature ovarian insufficiency.","authors":"Ana Carolina Japur de Sá Rosa E Silva, Maria Célia Mendes, Marcos Felipe Silva de Sá","doi":"10.61622/rbgo/2026rbgoedt3","DOIUrl":"10.61622/rbgo/2026rbgoedt3","url":null,"abstract":"","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oteseconazole <i>versus</i> fluconazole in the treatment of acute candidiasis: a systematic review and meta-analysis.","authors":"Elizabeth Honorato de Farias, Ana Gabriela Alves Pereira, Anderson Matheus Pereira da Silva, Lucas Silva Cabeça, Laila Leite Pacheco Vieira, Pedro Lucas Machado Magalhães, Josvaldo da Silva Viana, José Eleutério","doi":"10.61622/rbgo/2026rbgo32","DOIUrl":"10.61622/rbgo/2026rbgo32","url":null,"abstract":"<p><strong>Objective: </strong>Vulvovaginal candidiasis (VVC) is a common infection traditionally treated with fluconazole. Oteseconazole is a new oral antifungal offering a promising alternative. However, it is essential to assess if it has better efficacy than the treatment already used in VVC.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed PRISMA guidelines, searching PubMed, EMBASE, and Cochrane for studies comparing oteseconazole and fluconazole in acute VVC. Three randomized controlled trials were included. Odds ratios were calculated using a random-effects model.</p><p><strong>Results: </strong>The initial search yielded 203 results, but only three RCTs with 593 patients were included. Oteseconazole showed significantly higher rates of therapeutic and sustained clinical cure at day 14 and 28 compared to fluconazole (OR 2.56 and 2.08, respectively), with similar rates of mild to moderate adverse events. Risk of bias was high due to selective reporting.</p><p><strong>Conclusion: </strong>Oteseconazole appears to be a safe and more effective alternative to fluconazole for acute VVC, but further research and more robust studies are needed to confirm these findings.<b>PROSPERO Registry</b>: #CRD420251010309.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autoimmune progesterone dermatitis: diagnostic relevance and epidemiological analysis of 13 cases.","authors":"Nicole Touriel Bornsztein, Ariela Grabarz, Ana Laura Donaire Rapozero, Roberta Facchini Jardim Criado, Paulo Ricardo Criado, Gabriela Izzo Luiz, Luisa Homem de Mello Maciel Campilongo, Denise Maria Christofolini","doi":"10.61622/rbgo/2026rbgo30","DOIUrl":"10.61622/rbgo/2026rbgo30","url":null,"abstract":"<p><strong>Objective: </strong>Autoimmune progesterone dermatitis (APD) is a rare hypersensitivity to high levels of progesterone, with an as-yet unknown etiology. The objective of this study is to gather epidemiological data on patients with APD at an outpatient dermatology clinic.</p><p><strong>Methods: </strong>Medical records of patients diagnosed with APD, from menarche to menopause, seen at the dermatology clinic between 2004 and 2020 were reviewed.</p><p><strong>Results: </strong>Thirteen patients with APD were included. The mean age of symptom onset among APD patients was 24 years. The most prevalent clinical manifestation was urticaria, and the most common associated symptom was pruritus. The perimenstrual period was the most frequent aggravating factor, reported in 100% of cases. The intradermal progesterone test and autologous serum skin test were positive in approximately 60% of cases.</p><p><strong>Conclusion: </strong>Autoimmune progesterone dermatitis is an important differential diagnosis in female patients with dermatitis and should be considered during clinical evaluations.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal and spatial trends in isolated gastroschisis: a population-based study in a middle-income setting.","authors":"Izabelly Oliveira Corsi Nogueira, Ana Sílvia Scavacini Marinonio, Rosa Maria Vieira de Freitas, Monica La Porte Teixeira, Bernadette Cunha Waldvogel, Daniela Testoni Costa-Nobre","doi":"10.61622/rbgo/2026rbgo53","DOIUrl":"10.61622/rbgo/2026rbgo53","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the prevalence and neonatal mortality of isolated gastroschisis, assess temporal trends, identify risk factors for neonatal death, and describe its spatial distribution in a middle-income setting.</p><p><strong>Methods: </strong>This population-based study included all live births in São Paulo State, Brazil, from 2004 to 2017. Cases of isolated gastroschisis were identified from live birth and death certificates. Temporal trends in prevalence and neonatal mortality (0-27 days) were analyzed using Prais-Winsten regression to estimate annual percent change (APC). Maternal and neonatal factors associated with neonatal death were examined using Poisson and multivariate logistic regression. Spatial distribution across municipalities was described by quartiles according to maternal residence.</p><p><strong>Results: </strong>Among 8,441,498 live births, 1664 cases of isolated gastroschisis were identified (prevalence: 1.97 per 10,000). Neonatal mortality rate associated with isolated gastroschisis was 0.35 per 10,000 live births, with a lethality rate of 17.7%. Prevalence (APC 3.0%; 95% CI: -1.3 to 7.5) and mortality (0.6%; -3.5 to 4.8) remained stable over time. Lower gestational age, fewer prenatal visits, and severe growth restriction were independently associated with higher risk of neonatal death. Spatial analysis showed heterogeneous distribution, with most municipalities reporting no cases and higher prevalence and mortality concentrated in few areas.</p><p><strong>Conclusion: </strong>In this middle-income setting, isolated gastroschisis showed stable but higher prevalence and neonatal mortality than in high-income countries. The heterogeneous spatial pattern suggests regional disparities in risk and outcomes, highlighting the need for targeted public health strategies and further research on gastroschisis epidemiology.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}